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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

Clinical, physiologic, and biologic impact of environmental and behavioral interventions in neonates during a routine

Céline Catelin1, Sylvie Tordjman, Vincent Morin

  • 1Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital, Brest, France.

The Journal of Pain
|December 6, 2005
PubMed

Insights

Environmental and behavioral interventions (EBI) significantly reduced pain scores and heart rate in neonates during weighing. These findings suggest EBI can improve neonatal care and reduce stress responses.

Area of Science:

  • Neonatal care
  • Pediatric pain management
  • Evidence-based practice

Background:

  • Neonatal procedures like weighing can induce significant physiological and behavioral stress.
  • Environmental and behavioral interventions (EBI) are increasingly explored to mitigate procedural pain in neonates.
  • Understanding the impact of EBI across different gestational ages is crucial for optimizing neonatal care.

Purpose of the Study:

  • To evaluate the efficacy of combined environmental and behavioral interventions (EBI) on neonatal stress responses during weighing.
  • To assess the impact of EBI on behavioral, physiological, and biological stress markers in neonates of varying gestational ages.
  • To compare pain scores, heart rate, oxygen saturation, cortisol levels, and cerebral oxygenation with and without EBI.

Main Methods:

  • Randomized crossover study involving 45 neonates across three gestational age groups (<32, 32-36, and >37 weeks).
  • Each neonate underwent two weighing procedures: one with EBI and one control (without EBI).
  • Pain was assessed using the Neonatal Infant Pain Scale (NIPS) and Neonatal Pain and Discomfort Scale (EDIN); physiological data (heart rate, oxygen saturation, cerebral tissue oxygenation index [TOI]) and salivary cortisol were measured.

Main Results:

  • EBI significantly decreased NIPS and EDIN pain scores compared to the control condition.
  • Mean heart rate was significantly lower in neonates receiving EBI.
  • No significant differences in salivary cortisol levels were observed; however, a trend towards increased TOI was noted in preterm neonates (GA <37 weeks) with EBI.

Conclusions:

  • Combined environmental and behavioral interventions effectively reduce pain and physiological stress in preterm and term neonates during weighing procedures.
  • EBI demonstrates a positive impact on pain reduction and heart rate regulation, with potential benefits for brain oxygenation in younger preterm infants.
  • These findings support the integration of EBI into routine neonatal nursing care to enhance infant well-being.
Abstract

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